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2.
J Environ Manage ; 261: 110238, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32148308

RESUMO

Big data have the potential to improve nonmarket valuation, but their application has been scarce. To test this potential, we apply mobile phone data to the zonal travel cost method and measure recreational ecosystem services from Bukit Timah (representing an urban protected area) and Jurong Lake Gardens (an urban recreational park) in Singapore. The study results show that the annual recreational benefits of the recreational park (S$54,698,761 to S$66,805,454) outweighed the benefits of the protected area (S$6,947,974 to S$9,068,027). The count data structure reduced the flexibility of the mobile phone data application. Compared to survey data, however, mobile phone data could prevent random errors and visitor memory biases; monitor impacts of site quality changes over time; count visitors from multiple entrances; and be cost-efficient. Overall, these results highlight the potential of mobile phone data application to improve travel cost analysis.


Assuntos
Telefone Celular , Ecossistema , Parques Recreativos , Recreação , Singapura , Viagem
3.
Stud Health Technol Inform ; 268: 123-138, 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32141884

RESUMO

Behaviour change can refer to any transformation or modification of human behaviour. Within healthcare it refers to a broad range of activities and approaches that focus on the individual, community, or environmental influences on health-related behaviour. For e-Health (or digital health) it refers to behavioural impacts mediated through a specific e-Health intervention. However, there are also other health-related behaviour changes being quietly imposed upon both the populace and the healthcare professions broadly, by use of information and communications technologies for health. To better understand these deliberate or incidental impacts on the behaviour of healthcare consumers and providers alike, a scoping narrative review was performed using peer-reviewed and grey literature resources. Qualitative information was charted from the selected literature. This created an objective analysis of both contemporary and less commonly appreciated aspects of behaviour change in our 'digital' age. Many contemporary examples exist. The Internet and www brought alternate approaches moving from face-to-face or paper-based to websites, electronic diaries, and now mobile phones (particularly smartphones) to personalize health-related behaviour change in a myriad of diseases and conditions. Segments of the population have also exhibited health-related behaviour change through their growing www-based health-information seeking. More recent examples include 'spontaneous telemedicine' where physicians have changed the behaviour of themselves and colleagues through use of Instant Messaging, e.g., WhatsApp. Patients are also changing their behaviour spontaneously through taking and providing 'medical selfies'. However, the recent and rapid growth in accessibility and popularity of social media has markedly impacted behaviour change through the speed with which information can be spread, by both legitimate users and socialbots. Insidious examples include spread of health-related 'misinformation' (e.g., vaginal cleansing,), and now 'disinformation' (e.g., the 'anti-vaccination' movement, now resulting in recurrence of once eradicated diseases). These, and other examples, represent the broader, sometimes incidental, impact of some current e-health approaches on health-related behaviour change and should be identified and acknowledged as such. Doing so may fundamentally change opinion and efforts to redirect elements of behaviour change and aspects of behaviour change theory in unexpected ways.


Assuntos
Telefone Celular , Mídias Sociais , Telemedicina , Comunicação , Feminino , Comportamentos Relacionados com a Saúde , Humanos
4.
BMC Public Health ; 20(1): 49, 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31931773

RESUMO

BACKGROUND: In low-and-middle-income countries community health workers are the core component of the PHC system as they act as a liaison between the communities and the healthcare facilities. Evidence suggests that the services offered by these workers have helped in the decline of maternal and child morbidity and mortality rates and the burden of communicable and non-communicable diseases. However, the coverage and the overall progress towards achieving the SDG targets is very sluggish. The recent consensus concerning this current pace of progress, is that it relates to financial and human resources constraints. CHWs are overburdened as they are expected to accomplish more although they may not obtain the required support to perform their duties. The health systems of LMICs, have given very little attention to the work environment of CHWs; which has negatively affected CHWs productivity, and quality of services. This debate is intended to explore the potential of mobile phone technology in LMICs for improving CHWs performance and effectiveness. DISCUSSION: To improve CHWs productivity, some studies involved the use of mobile phones for data collection and reporting, while other studies used mobile technology for patient to provider communication, patient education, CHWs supervision, and monitoring and evaluation. A wide range of benefits exists for using mobile phones including reduction in CHWs workload, improvement in data collection, reporting and monitoring, provision of quality healthcare services, supportive supervision, better organization of CHWs tasks and improvement in community health outcomes. However, a number of studies suggests that CHWs encounter unique challenges when adopting and using mobile health solutions for health service delivery such as, lack of CHWs training on new mHealth solutions, weak technical support, issues of internet connectivity and other administrative challenges. Future research efforts should be directed to explore health system readiness for adopting sustainable mHealth solutions to improve CHWs workflows in LMICs. CONCLUSION: Future research efforts and policy dialogue should be directed to explore health system readiness for adopting sustainable mHealth solutions to improve CHWs workflows in LMICs.


Assuntos
Telefone Celular , Agentes Comunitários de Saúde , Países em Desenvolvimento , Desempenho Profissional , Eficiência , Humanos , Atenção Primária à Saúde/organização & administração , Qualidade da Assistência à Saúde , Telemedicina , Fluxo de Trabalho
5.
Z Kinder Jugendpsychiatr Psychother ; 48(1): 33-46, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30422059

RESUMO

This meta-review integrates the current meta-analysis literature on the efficacy of internet- and mobile-based interventions (IMIs) for mental disorders and somatic diseases in children and adolescents. Further, it summarizes the moderators of treatment effects in this age group. Using a systematic literature search of PsycINFO and MEDLINE/PubMed, we identified eight meta-analyses (N = 8,417) that met all inclusion criteria. Current meta-analytical evidence of IMIs exists for depression (range of standardized mean differences, SMDs = .16 to .76; 95 % CI: -.12 to 1.12; k = 3 meta-analyses), anxiety (SMDs = .30 to 1.4; 95 % CI: -.53 to 2.44; k = 5) and chronic pain (SMD = .41; 95 % CI: .07 to .74; k = 1) with predominantly nonactive control conditions (waiting-list; placebo). The effect size for IMIs across mental disorders reported in one meta-analysis is SMD = 1.27 (95 % CI: .96 to 1.59; k = 1), the effect size of IMIs for different somatic conditions is SMD = .49 (95 % CI: .33 to .64; k = 1). Moderators of treatment effects are age (k = 3), symptom severity (k = 1), and source of outcome assessment (k = 1). Quality ratings with the AMSTAR-2-checklist indicate acceptable methodological rigor of meta-analyses included. Taken together, this meta-review suggests that IMIs are efficacious in some health conditions in youths, with evidence existing primarily for depression and anxiety so far. The findings point to the potential of IMIs to augment evidence based mental healthcare for children and adolescents.


Assuntos
Transtornos de Ansiedade/terapia , Telefone Celular , Transtorno Depressivo/terapia , Internet , Adolescente , Ansiedade/terapia , Criança , Depressão/terapia , Humanos , Resultado do Tratamento
6.
Waste Manag ; 101: 200-209, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31622865

RESUMO

Present work was focused on recovering gold (Au) from the printed circuit boards (PCBs) of discarded cellphone by bioleaching assisted continuous foam fractionation. First, the cyanide-producing strains of Pseudomonas putida and Bacillus megaterium were co-cultured in order to supply a high cyanide concentration in the nutrient solution for mobilizing Au from waste PCBs (WPCBs). Bioleaching conditions were optimized by using response surface methodology. Under the suitable bioleaching conditions of pH of 10.0, pulp density of 5 g/L and leaching time of 34 h, the Au mobilization percentage was 83.59%. The leaching liquor with an Au concentration of 1.34 mg/L could be used as the feeding solution of continuous foam fractionation after removing solid particles and cell biomass. In order to strengthen foam drainage, a novel internal component of foam fractionation column was developed. Under the suitable operation conditions of CTAB concentration of 0.2 g/L, volumetric air flow rate of 100 mL/min and feed flow rate of 10 mL/min, the enrichment ratio and recovery percentage of Au were 43.62 and 87.46%, respectively. This study is expected to provide an effective strategy to recover Au from WPCBs, and to supplement the depleting natural resources.


Assuntos
Telefone Celular , Resíduo Eletrônico , Cobre , Ouro , Reciclagem
8.
Ecotoxicol Environ Saf ; 188: 109786, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31698176

RESUMO

In the last few decades, tremendous increase in the use of wireless electronic gadgets, particularly the cell phones, has significantly enhanced the levels of electromagnetic field radiations (EMF-r) in the environment. Therefore, it is pertinent to study the effect of these radiations on biological systems including plants. We investigated comparative cytotoxic and DNA damaging effects of 900 and 1800 MHz EMF-r in Allium cepa (onion) root meristematic cells in terms of mitotic index (MI), chromosomal aberrations (CAs) and single cell gel electrophoresis (comet assay). Onion bulbs were subjected to 900 and 1800 MHz (at power densities 261 ±â€¯8.50 mW m-2 and 332 ±â€¯10.36 mW m-2, respectively) of EMF-r for 0.5 h, 1 h, 2 h, and 4 h. Root length declined by 13.2% and 12.3%, whereas root thickness was increased by 46.7% and 48.3% after 4 h exposure to 900 MHz and 1800 MHz, respectively. Cytogenetic studies exhibited clastogenic effect of EMF-r as depicted by increased CAs and MI. MI increased by 36% and 53% after 2 and 4 h exposure to 900 MHz EMF-r, whereas it increased by 41% and 67% in response to 1800 MHz EMF-r. Aberration index was increased by 41%-266% and 14%-257% during 0.5-4 h of exposure to 900 MHz and 1800 MHz, respectively, over the control. EMF-r exposure decreased % head DNA (DNAH) and increased % tail DNA (DNAT) and olive tail moment (OTM) at both 900 and 1800 EMF-r. In 4 h exposure treatments, head DNA (%) declined by 19% and 23% at 900 MHz and 1800 MHz, respectively. DNAT and OTM were increased by 2.3 and 3.7 fold upon exposure to 900 MHz EMF-r over that in the control, whereas 2.8 and 5.8 fold increase was observed in response to 1800 MHz EMF-r exposure for 4 h and the difference was statistically significant. The study concludes that EMF-r in the communication range (900 and 1800 MHz) adversely affect root meristems in plants and induce cytotoxic and DNA damage. EMF-r induced DNA damage was more pronounced at 1800 MHz than that at 900 MHz.


Assuntos
Aberrações Cromossômicas/efeitos da radiação , Dano ao DNA , Campos Eletromagnéticos/efeitos adversos , Radiação Eletromagnética , Meristema/efeitos da radiação , Cebolas/efeitos da radiação , Telefone Celular , Ensaio Cometa , Relação Dose-Resposta à Radiação , Meristema/citologia , Meristema/genética , Índice Mitótico , Cebolas/citologia , Cebolas/genética , Fatores de Tempo
9.
Diabetes Res Clin Pract ; 158: 107895, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31669408

RESUMO

With the increasing use of mobile phones, mHealth has grown to be a very promising subject. However, mHealth programs haven't been widespread in many countries, especially in developing countries. Health-related phone applications, and in particular diabetes-related mobile apps, are gaining more popularity by the day. Yet, there are still some concerns about the safety and effectiveness of these apps. In this short commentary, we will discuss the simple uses of mobile phones and how they can contribute to the communication between patients and health professional providers.


Assuntos
Uso do Telefone Celular/tendências , Telefone Celular/instrumentação , Diabetes Mellitus/terapia , Telemedicina/métodos , Humanos
10.
Rev Assoc Med Bras (1992) ; 65(10): 1321-1326, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721966

RESUMO

BACKGROUND: Technological advances of the 21st century have provided greater communication, regardless of socioeconomic class and age group. Actions to promote the development of health applications are emerging around the world. OBJECTIVE: To provide a perspective on the viability and usability of mobile applications dedicated to radiotherapy patients for remote support to health professionals proposing solutions to encourage Brasil in the development of these digital tools. METHODS: Cross-sectional exploratory study by systematic review and literature review. We searched the PubMed, BVS, IBGE, and WHO databases, from 2014 to 2018. RESULTS: 6 articles were found with topics related to the use of mobile applications in the health area, two of which were published in Portuguese and four in the English, on oncology, from 2014 to 2018. CONCLUSIONS: We did not find an expressive number of works on this subject in Brasil. Mobile applications have the potential to assist in the remote support of radiotherapy patients. The latest studies suggest the need for a regulation of data protection protocols to be deployed.


Assuntos
Oncologia/instrumentação , Aplicativos Móveis , Radioterapia/instrumentação , Telemedicina/instrumentação , Brasil , Telefone Celular/instrumentação , Comunicação , Estudos Transversais , Pessoal de Saúde , Humanos , Interface Usuário-Computador
11.
Pan Afr Med J ; 33: 305, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31723372

RESUMO

Introduction: Every 90 seconds, a woman dies of complications related to pregnancy and childbirth, resulting in more than 340,000 maternal deaths a year. Antenatal care (ANC) and postnatal care (PNC) are significant determinants of maternal health and, particularly, safe motherhood. Antenatal care is an important predictor of safe delivery and provides health information and services that can improve the health of women and infants. mHealth broadly encompasses the use of mobile telecommunication and multimedia technologies as they are integrated within increasingly mobile and wireless health care delivery systems. This study aimed at assessing the acceptable implementation modalities of mHealth intervention on pregnant Women in Dschang health district, West Region of Cameroon.ng ba. Methods: This was a cross sectional descriptive study in the Dschang health district, West region of Cameroon. Key informants were all pregnant women from 18 years and above and a total of 372 pregnant women were included. This study was carried out from March to July 2017. Results: Majority of the women, that is, 252(67.74%) were married, 117(31.45%) declaredtheir status as being single, while 3(0.81%) were devorced. Out of the 335 women that declared wanting an mHealth intervention, 41.79% of this number preferred SMS texts in the afternoon, 111(33.13%) in the evening, 46(13.73%) anytime and 38(11.34%) in the morning hours. A total of 83.33% women confirmed using telephone services. Conclusion: This study reveals that cell phones would be the acceptable medium of providing pregnancy and postpartum support to women in the Dschang health district. This is justified by the fact that a vast majority of women interviewed had access to a cell phone and referred to it as their desired and accepted means of communication.


Assuntos
Cuidado Pós-Natal/métodos , Cuidado Pré-Natal/métodos , Telemedicina/métodos , Adolescente , Adulto , Camarões , Telefone Celular , Estudos Transversais , Feminino , Humanos , Gravidez , Mensagem de Texto , Adulto Jovem
12.
J Craniofac Surg ; 30(6): 1906-1910, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31756878

RESUMO

PURPOSE: This study aims to determine the number, symmetry, shape and individual characteristic of palatal rugae. METHODS: In our study, we performed on subjects ages 16 to 57 (23.01 ±â€Š7.12), ranging from a total of 230 (108 female and 122 male). Alginant impression material from each took dimensions of the upper jaw. Then casts were obtained by pouring hard casts. The shapes, lengths, and directions of rugae measured on these casts. The palatine photos were taken by using a mobile phone-Samsung brand with 12 MP camera and an orthodontic mirror. The casts and photographs were selected at random belonging to 100 subjects. Selected at random 10 photographs were matched among 100 casts. The ratios of correct matches were determined. RESULTS: In our study, the total number of palatal rugae was found as 9.49 ±â€Š1.87 in females and 9.42 ±â€Š1.92 in males. The most detected rugae pattern was wavy on both females and males. The most rarely seen rugae pattern was converged in the males and circular in the females. Regarding lengths of rugae, the most detected rugae pattern was the primary one. Regarding the direction of rugae pattern, positive-sided one was the most dominant in both genders. We determined the ratio of matching the casts belonging to Palatine with the photos as 63.5%. The number of rugae aged under 18 and above 41 was found to be statistically significant (P = 0.003), but the number of curved and positive-sided rugae in older ages was not found to be statistically significant. CONCLUSIONS: Compared with data from earlier studies, the shapes, length, and direction of palatal rugae were seen specific in every individual, and it was seen to have discriminating characteristics among different populations. The possible differences in individual specific palatal rugae require further studies involving larger samples.


Assuntos
Mucosa Bucal , Adolescente , Adulto , Idoso , Telefone Celular , Materiais para Moldagem Odontológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Contenções , Adulto Jovem
13.
BMC Infect Dis ; 19(1): 977, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31747889

RESUMO

BACKGROUND: Rabies is estimated to cause 59,000 deaths and economic losses of US$8.6 billion every year. Despite several years of rabies surveillance and awareness programmes, increased availability of post-exposure prophylaxis vaccinations and dog population control, the disease still remains prevalent in Sri Lanka. This study reports the roll-out of a high number, high coverage canine rabies vaccination campaign in Sri Lanka, providing estimates for the vaccination coverage achieved, analysing the local dog demographics, and identifying barriers of attendance to static vaccination clinics. METHODS: A mass dog vaccination campaign was undertaken in Negombo, Sri Lanka. The campaign was composed of static point and door-to-door vaccination stages, with a final survey of vaccination coverage. A large volume of data on the distribution, health, and signalment of vaccinated dogs was collected through a mobile phone application. A logistic regression model was developed to investigate which socio-spatial and dog-related factors influenced attendance of owners to static vaccination points. RESULTS: The campaign vaccinated over 7800 dogs achieving a vaccination coverage of 75.8%. A dog:human ratio of 1:17 was estimated. Most dogs were owned, and the dog population was mostly male, adult, and non-sterilized. Unawareness, unavailability and handling problems were the most common reasons given by owners to explain failure to attend a static vaccination point. The regression analysis showed that increasing distance to a static point, in addition to young age and poor health of the dog, were associated with a decrease in the likelihood of attendance to a static vaccination points. CONCLUSION: This study demonstrates the feasibility of high number, high coverage vaccination campaigns in Sri Lanka. The information on dog ecology and barriers of attendance to static point vaccination clinics will facilitate development of future vaccination campaigns.


Assuntos
Doenças do Cão/prevenção & controle , Vacinas Antirrábicas/imunologia , Raiva/prevenção & controle , Cobertura Vacinal/métodos , Animais , Telefone Celular , Doenças do Cão/imunologia , Cães , Feminino , Humanos , Programas de Imunização , Modelos Logísticos , Masculino , Raiva/imunologia , Sri Lanka , Inquéritos e Questionários , Cobertura Vacinal/estatística & dados numéricos
14.
Afr J Reprod Health ; 23(3): 68-78, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31782633

RESUMO

The Saving Mothers Project was conducted from September 2015 to March 2017 in Bunda and Tarime Districts, Mara Region, Tanzania. The purpose of this project was to train community health workers (CHWs) to use mobile phones applications to register and educate pregnant women about safe deliveries and encourage them to access skilled health care providers for antenatal care and delivery, and to provide nurses and CHWs with clean birth kits with misoprostol to distribute to women. The birth kits were for use in case women could not access the health facility, or if the health facility was lacking supplies at the time of delivery. The overall goal of the study was to reduce the maternal mortality rate by increasing women's access to health services where possible, and to clean supplies when a non-facility birth was unavoidable. This paper reports on a mixed methods evaluation of the project including a survey of over two thousand four hundred women, and focus groups with women, community health workers, and nurses participating in the project. The results of the survey and focus groups demonstrate a high degree of satisfaction with the birth kits and misoprostol and an increase in facility birth rates where the project was implemented. Differences between the two districts illustrate that policy maker support is key to successful implementation.


Assuntos
Agentes Comunitários de Saúde/educação , Acesso aos Serviços de Saúde , Serviços de Saúde Materna/organização & administração , Mortalidade Materna , Tocologia/educação , Misoprostol/provisão & distribução , Ocitócicos/provisão & distribução , Hemorragia Pós-Parto/prevenção & controle , Adulto , Telefone Celular , Feminino , Humanos , Misoprostol/administração & dosagem , Aplicativos Móveis , Ocitócicos/administração & dosagem , Guias de Prática Clínica como Assunto , Gravidez , Resultado da Gravidez , Gestantes , Cuidado Pré-Natal , População Rural , Tanzânia , Adulto Jovem
16.
Matern Child Health J ; 23(12): 1658-1669, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31584144

RESUMO

Objectives mHealth interventions for MNCH have been shown to improve uptake of antenatal and neonatal services in low- and middle-income countries (LMICs). However, little systematic analysis is available about their impact on infant health outcomes, such as reducing low birth weight or malnutrition among children under the age of five. The objective of this study is to determine if an age- and stage-based mobile phone voice messaging initiative for women, during pregnancy and up to 1 year after delivery, can reduce low birth weight and child malnutrition and improve women's infant care knowledge and practices. Methods We conducted a pseudo-randomized controlled trial among pregnant women from urban slums and low-income areas in Mumbai, India. Pregnant women, 18 years and older, speaking Hindi or Marathi were enrolled and assigned to receive mMitra messages (intervention group N = 1516) or not (Control group N = 500). Women in the intervention group received mMitra voice messages two times per week throughout their pregnancy and until their infant turned 1 year of age. Infant's birth weight, anthropometric data at 1 year of age, and status of immunization were obtained from Maternal Child Health (MCH) cards to assess impact on primary infant health outcomes. Women's infant health care practices and knowledge were assessed through interviews administered immediately after women enrolled in the study (Time 1), after they delivered their babies (Time 2), and after their babies turned 1 year old (Time 3). 15 infant care practices self-reported by women (Time 3) and knowledge on ten infant care topics (Time 2) were also compared between intervention and control arms. Results We observed a trend for increased odds of a baby being born at or above the ideal birth weight of 2.5 kg in the intervention group compared to controls (odds ratio (OR) 1.334, 95% confidence interval (CI) 0.983-1.839, p = 0.064). The intervention group performed significantly better on two infant care practice indicators: giving the infant supplementary feeding at 6 months of age (OR 1.4, 95% CI 1.08-1.82, p = 0.009) and fully immunizing the infant as prescribed under the Government of India's child immunization program (OR 1.531, 95% CI 1.141-2.055, p = 0.005). Women in the intervention group had increased odds of knowing that the baby should be given solid food by 6 months (OR 1.89, 95% CI 1.371-2.605, p < 0.01), that the baby needs to be given vaccines (OR 1.567, 95% CI 1.047-2.345, p = 0.028), and that the ideal birth weight is > 2.5 kg (OR 2.279, 95% CI 1.617-3.213, p < 0.01). Conclusions for Practice This study provides robust evidence that tailored mobile voice messages can significantly improve infant care practices and maternal knowledge that can positively impact infant child health. Furthermore, this is the first prospective study of a voice-based mHealth intervention to demonstrate a positive impact on infant birth weight, a health outcome of public health importance in many LMICs.


Assuntos
Telefone Celular , Transtornos da Nutrição Infantil/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Cuidado do Lactente/métodos , Desnutrição/prevenção & controle , Mães/psicologia , Voz , Adulto , Criança , Feminino , Humanos , Índia , Lactente , Saúde do Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Mães/estatística & dados numéricos , Áreas de Pobreza , Gravidez , Estudos Prospectivos , Telemedicina , Adulto Jovem
17.
PLoS Med ; 16(10): e1002939, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31647821

RESUMO

BACKGROUND: The coverage of community-based maternal, neonatal, and child health (MNCH) services remains low, especially in hard-to-reach areas. We evaluated the effectiveness of a mobile-phone-and web-based application, Innovative Mobile-phone Technology for Community Health Operations (ImTeCHO), as a job aid to the government's Accredited Social Health Activists (ASHAs) and Primary Health Center (PHC) staff to improve coverage of MNCH services in rural tribal communities of Gujarat, India. METHODS AND FINDINGS: This open cluster-randomized trial was conducted in 22 PHCs in six tribal blocks of Bharuch and Narmada districts in India. The ImTeCHO mobile-phone-and web-based application included various technology-based job aids to facilitate scheduling of home visits, screening for complications, counseling during home visits, and supportive supervision by PHC staff. Primary outcome indicators were a composite index calculated based on coverage of important MNCH services and coverage of at least two home visitations by ASHA within the first week of birth. Primary analysis was intention to treat (ITT). Generalized Estimating Equation (GEE) was used to account for clustering. Eleven PHCs each were randomly allocated to the intervention (280 ASHAs, population: 234,134) and control (281 ASHAs, population: 242,809) arms. The intervention was implemented from February, 2016 to January, 2017. At the end of the implementation, 6,493 mothers were surveyed. Most of the surveyed women were tribal (5,571, 85.8%), and reported having a government-issued certificate for living below poverty line (4,916, 75.7%). The coverage of at least two home visits within first week of birth was 32.4% in the intervention clusters compared to 22.9% in the control clusters (adjusted effect size 10.2 [95% CI: 6.4, 14.0], p < 0.001). Mean number of home visits within first week of birth was 1.11 and 0.80 for intervention and control clusters, respectively (adjusted effect size 0.34 [95% CI: 0.23, 0.45], p < 0.001). The composite coverage index was 43.0% in the intervention clusters compared to 38.5% (adjusted effect size 4.9 [95% CI: 0.2, 9.5], p = 0.03) in the control clusters. There were substantial improvements in coverage home visits by ASHAs during antenatal period (adjusted effect size 15.7 [95% CI: 11.0, 20.4], p < 0.001), postnatal period (adjusted effect size 6.4, [95% CI: 3.2, 9.6], p <0.001), early initiation of breastfeeding (adjusted effect size 7.8 [95% CI: 4.2, 11.4], p < 0.001), and exclusive breastfeeding (adjusted effect size 13.4 [95% CI: 8.9, 17.9], p < 0.001). Number of infant and neonatal deaths was similar in the two arms in the ITT analysis. The limitations of the study include potential risk of inaccuracies in reporting events that occurred during pregnancy by the mothers and the duration of intervention being 12 months, which might be considered short. CONCLUSIONS: In this study, we found that use of ImTeCHO mobile- and web-based application as a job aid by government ASHAs and PHC staff improved coverage and quality of MNCH services in hard-to-reach areas. Supportive supervision, change management, and timely resolution of technology-related issues were critical implementation considerations to ensure adherence to the intervention. TRIAL REGISTRATION: Study was registered at the Clinical Trial Registry of India (www.ctri.nic.in). Trial number: CTRI/2015/06/005847. The trial was registered (prospective) on 3 June, 2015. First enrollment was done on 26 August, 2015.


Assuntos
Serviços de Saúde da Criança/organização & administração , Serviços de Saúde Materna/organização & administração , Neonatologia/organização & administração , Telemedicina/métodos , Adulto , Telefone Celular , Análise por Conglomerados , Agentes Comunitários de Saúde , Aconselhamento , Feminino , Serviços de Assistência Domiciliar , Visita Domiciliar , Humanos , Índia/epidemiologia , Recém-Nascido , Internet , Masculino , Gravidez , Desenvolvimento de Programas , Serviços de Saúde Rural/organização & administração , População Rural , Resultado do Tratamento , Adulto Jovem
18.
BMC Health Serv Res ; 19(1): 699, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615484

RESUMO

BACKGROUND: Dengue is an emerging vector disease with frequent outbreaks in Nepal that pose a major threat to public health. Dengue control activities are mostly outbreak driven, and still lack systematic interventions while most people have poor health-related knowledge and practices. Mobile Short Message Service (SMS) represents a low-cost health promotion intervention that can enhance the dengue prevention knowledge and practices of the affected communities. This study aimed to explore the acceptability, appropriateness, and effectiveness of mobile SMS intervention in improving dengue control practices. METHODS: This study was an implementation research that used mixed-methods design with intervention. A total of 300 households were divided into three groups, i.e. one control group, one dengue prevention leaflet (DPL) only intervention group and one DPL with mobile SMS intervention group (DPL + SMS). We used a structured questionnaire to collect information regarding participants' knowledge and practice of dengue prevention. We conducted in-depth interviews with key informants to measure acceptability and appropriateness of intervention. Mean difference with standard deviation (SD), one-way ANOVA, paired t-test and regression analyses were used to assess the effectiveness of the interventions. Thematic analysis was used to assess the acceptability, and appropriateness as well as barriers and enablers of the intervention. RESULTS: The DPL + SMS intervention produced significantly higher mean knowledge difference (32.7 ± 13.7 SD vs. 13.3 ± 8.8 SD) and mean practice difference (27.9 ± 11.4 SD vs 4.9 ± 5.4 SD) compared to the DPL only group (p = 0.000). Multivariate analysis showed that the DPL + SMS intervention was effective to increase knowledge by 28.6 points and practice by 28.1 points compared to the control group. The intervention was perceived as acceptable and appropriate by the study participants and key stakeholders. Perceived barriers included reaching private network users and poor network in geographically remote areas, while enabling factors included mobile phone penetration, low cost, and shared responsibility. CONCLUSIONS: Mobile SMS is an effective, acceptable and appropriate health intervention to improve dengue prevention practices in communities. This intervention can be adopted as a promising tool for health education against dengue and other diseases.


Assuntos
Telefone Celular/estatística & dados numéricos , Dengue/prevenção & controle , Promoção da Saúde/métodos , Adulto , Análise de Variância , Serviços de Saúde Comunitária/métodos , Serviços de Saúde Comunitária/normas , Feminino , Nível de Saúde , Humanos , Masculino , Nepal , Projetos Piloto , Inquéritos e Questionários , Mensagem de Texto/estatística & dados numéricos
19.
PLoS Negl Trop Dis ; 13(10): e0007746, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31589612

RESUMO

We developed a novel and portable fluorescent sensor that integrates a lateral flow assay with a quantum dot (Qdots) label and a mobile phone reader for detection of specific antibodies in human serum. We evaluated the utility of this assay to test for antibodies to the Taenia solium rT24H antigen. It was a retrospective study by examining 112 positive human sera from patients with neurocysticercosis (NCC) including samples from patients with single viable cyst (n = 18), two or more viable cysts (n = 71), and subarachnoid (racemose) cysts (n = 23). These samples were collected from previous study subjects in Lima, Peru under an approved study protocol in Peru. The sera were made anonymous under a protocol approved by the CDC Institutional Review Board. Definitive diagnosis of the subject was established by computed-tomography and/or magnetic resonance imaging. To test the specificity of the assay, we evaluated a panel of serum samples obtained from patients with other infections (n = 24), and serum samples from persons in the United States and Egypt who had not traveled outside their country, and therefore are presumed negative for cysticercosis (n = 128). The assay specificity in the negative panel was 99% (95-100%) while assay sensitivity was 89% (79-95%) in NCC patients with two or more viable cysts. Our assay has performance characteristics similar to those of traditional platforms for the detection of NCC and shows promise as a mobile phone reader-based point-of-care test for antibody detection.


Assuntos
Anticorpos Anti-Helmínticos/sangue , Formação de Anticorpos , Telefone Celular , Testes Imunológicos/métodos , Neurocisticercose/diagnóstico , Testes Imediatos , Pontos Quânticos , Animais , Antígenos de Helmintos/imunologia , Cisticercose , Estudos de Viabilidade , Humanos , Imagem por Ressonância Magnética , Neurocisticercose/imunologia , Estudos Retrospectivos , Sensibilidade e Especificidade , Taenia solium
20.
Rev Esc Enferm USP ; 53: e03520, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31618315

RESUMO

OBJECTIVE: To analyze drug content in games for mobile devices. METHOD: An exploratory study implementing a qualitative approach. The collective health critical perspective was taken in relation to the ideology of prohibitionist education and the foundations of emancipatory education in the area of drugs. Games about drugs were selected in a virtual store based on inclusion and exclusion criteria. Content analysis was performed with the support of an interpretative model specific to digital games used to identify textual and procedural messages in games. RESULTS: Nineteen (19) games were analyzed. Most of them reiterate prohibitionist positions and play the role of transmitting prescriptive and normative information, assuming the objective of disciplining risk behaviors. This evident limitation demonstrates an important contradiction that games are strategies of contemporary language, with outdated and unscientific content. CONCLUSION: Despite the potential of virtual tools, the analyzed games are marked by intense simplification regarding the phenomenon of drug use and stimulate fast preprogrammed responses that do not go beyond memorization and conditioning. A need for scientific updates and incorporation of critical educational content persists in the area.


Assuntos
Telefone Celular , Transtornos Relacionados ao Uso de Substâncias , Jogos de Vídeo/estatística & dados numéricos , Feminino , Humanos , Assunção de Riscos
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